Individual provider Active NPI

Marshall Hanson, DDS

  • Dentist
  • Draper, UT
National Provider Identifier
1043419245
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D7316 Issued in AZ
Practice address
949 E 12400 S Ste A2
Draper, UT 84020
Phone
(801) 571-6541
NPI assigned
Jul 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D7316 AZ Primary

Addresses

Primary practice location

949 E 12400 S Ste A2
Draper, UT 84020

Mailing address

622 E Treven PL
Draper, UT 84020-7656
Phone (480) 881-7022

Other practice location 1

21 W White Mountain Blvd
Lakeside, AZ 85929-7001
Phone (928) 367-4276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D7316AZMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1043419245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 E TREVEN PL",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207656",
            "telephone_number": "480-881-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 E 12400 S STE A2",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "84020",
            "telephone_number": "801-571-6541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 W White Mountain Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeside",
            "state": "AZ",
            "postal_code": "859297001",
            "country_code": "US",
            "telephone_number": "928-367-4276",
            "fax_number": "928-367-1539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANSON",
        "first_name": "MARSHALL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D7316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.